Flashcards in Amenorrhea, Oligomenorrhea Deck (56)
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1
What is primary amenorrhea
no menses by age 13 in absence of secondary sexual characteristics or NO menses by age 15 with secondary sexual characteristics
2
What is secondary amenorrhea
no menses for >60mo or 3 cycles after documented menarche
3
what is oligomenorrhea?
episodic vaginal bleeding occurring at intervals >35d
4
How do you remember puberty stages
boobs, pubes, flow grow
5
Tanner stage 3?
Breast; no contour, enlargement of breast and areola
6
When does sexual differentiation occur in embryology?
6 weeks
7
What happens when males differential?
Wolffian (mesonephric) ducts; develops into epididymis, vas deferens, seminal vesicle, ejaculatory duct
8
What do wolffian (mesonephric) ducts differential into?
epididymis, vas deferens, seminal vesicles, ejaculatory duct.
9
What cells lead to male sexual differentiation?
leydig cells (internal/external) and sertoli cells (shuts down female (internal)) sexual differentiation through MID
10
how does testosterone break down to di hydrotestosterone?
5 alpha reductase
11
what happens with 5 alpha reductase deficiency
no external male genitalia (penis, scrotum, prostate)
12
What is the other name for Mayer-Rokitansky-kuster-hauser syndrome?
Mullerian agenesis
13
What is the pneumonic to remember the male internal genitalia?
SEED (seminal vesicles, ejaculatory duct, epididymis, deferens(vas)
14
Where do the male internal genitalia derive from?
Wolffian (mesonephric) duct
15
What is the other name for the mesonephric duct?
wolfian duct (male
16
What are the structures that derive from the mullein (paramesonephric) ducts)
fallopian tubules, uterus, upper part of vagina
17
What happens in mullein agensis
primary amenorrhea with FULLY developed secondary sex characteristic.
18
how do sertoli cells work?
shut down female (internal) sexual characteristics (for men) through MIF
19
what is the karyotype in androgen insensitivity syndrome?
46XY
20
What is imperforate hymen associated with?
simplest defect that results in primary amenorrhea. May be associated with cyclic pelvic pain and a perirectal mass from sequestration of blood in vagina (hemtocolpos)
21
What is hematocolpos?
perirectal mass from sequestration of blood in vagina
22
what is the initial Bloodwork in primary amenorrhea?
bhcg, tsh, FSH, LH, prolactin, pelvis US (do they have a uterus?)
23
High FSH and primary amenorrhea is what ?
turner syndrome
24
What are the major causes of secondary amenorrhea (aside from pregnancy?)
Anorexia, PCOS, stress, excessive exercise, prolactinoma,
25
when'd o you get bitemporal hemianopsia?
with prolactinoma
26
what is the cause of post d &c amenorrhea?
ashermans
27
what physical exam findings coincide with secondary amenorrhea?
hyperandrogen, galactorrhea, low weight, high weight
28
add total testosterone if you are working up what?
PCOS
29
What do you do with a high prolactin?
repeat because often false +ve
30